Osteosynthesis and Trauma Care 2002; 10(2): 64-67
DOI: 10.1055/s-2002-34679
Original Articles

© Georg Thieme Verlag Stuttgart · New York

Primary Treatment of Abdominal Trauma

C. Fialka1 , M. Fuchs2 , C. Sebök1 , M. Greitbauer1 , V. Vécsei1
  • 1University Hospital Vienna, Department of Traumatology, Vienna, Austria
  • 2General Hospital St. Pölten, Department of Traumatology, St. Pölten, Austria
Further Information

Publication History

Publication Date:
15 October 2002 (online)

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Abstract

The algorithm of diagnostics and therapy in abdominal trauma patients is discussed using the data from an urban level one trauma centre. In an eight-years period 338 patients with abdominal injuries were admitted. Blunt trauma (n = 193) mainly leads to morphological alterations of the parenchymal organs, predominantly to the spleen. Primary haemodynamic condition as well as additional injuries decide whether primary therapy is operative or non-operative. The most important diagnostic tool seems to be ultrasound, used as a primary screening method. After stabilisation of the patient a contrast CT scan is the golden standard for further diagnosis. In cases of penetrating injuries (n = 145) local surgical revision has to be performed to determine the possible peritoneal penetration. Laparoscopy or primary laparotomy are the subsequent procedures to clarify concomitant intra-abdominal lesions. In cases of therapy resistant haemodynamic instability, emergency Iaparotomy has to be performed. Ultrasound and CT scan have a minor role in these patients protocol. In cases of colonic injury a colostomy is not obligatory, because of the superior result in one-step repair concerning complication rate and infections.

References

Christian FialkaM. D 

University Hospital Vienna - Department of Traumatology

Währinger Gürtel 18-20

1090 Vienna

Austria

Phone: + 43-1/4 04 00-59 02

Fax: + 43-1/42 45 07

Email: Christian.Fialka@akh-wien.ac.at